Withdrawal is a situation that can occur when quitting drugs or alcohol, especially for people who have been using substances heavily for a long time. Some types of withdrawal can be very dangerous and potentially deadly, while others are more likely to only cause uncomfortable symptoms. The dangers of withdrawal depend largely upon the substances that are causing withdrawal.
Withdrawal is a set of symptoms that occurs in your body when you stop using alcohol or drugs. This can occur with illegal drugs, but it can also occur with prescription medications — even when they are used as prescribed. Withdrawal will normally occur when a substance is used heavily over a prolonged period and then suddenly stopped or substantially reduced.
The reason drugs and alcohol can be so appealing to use is that they activate receptors in the brain that cause physical and emotional changes. Different drugs will activate different types of receptors, causing different symptoms.
When drugs or alcohol are used heavily over a long period of time, the receptors in the brain are constantly overstimulated. The brain reduces the sensitivity of these receptors to return the brain to its normal balance. This leads to the substance having less effect over time, but it also creates dependence — a condition in which the brain depends on the presence of a substance to function normally.
When a substance is suddenly stopped, the receptors in the brain still have reduced sensitivity because the brain is still operating as if the substance is present. This is what leads to withdrawal. It takes the brain several days to readjust to normal levels, causing withdrawal symptoms to occur in the meantime.
Withdrawal symptoms will often be the opposite of the symptoms a substance causes. Drugs that are stimulants will have withdrawal symptoms that cause tiredness, while drugs that are depressants will cause hyperactivity. This is due to how the receptors in the brain are suppressed by the substance.
For example, opioids overstimulate opioid receptors and cause a dulled sensation of pain. The brain reduces the sensitivity of opioid receptors, causing the brain’s sensitivity to pain to return to roughly normal. When opioid use is stopped, the opioid receptors in the brain that dull pain are still very desensitized. This causes the symptom of pain — the opposite of dulled pain caused by opioids — until the brain readjusts the sensitivity of these receptors back to normal levels.
There are two important factors affecting how long physical withdrawal symptoms will last: the type of substance used and how heavily it has been used. The type of substance is important, as different substances affect different receptors in the brain. The speed at which the brain can restore normal receptor function will be different depending on the type of receptor.
How heavily a substance is used will also be an important factor, as this will determine how severely receptors have been suppressed. The brain of someone who uses a substance lightly may have little to no difficulty adjusting quickly, while a heavy user may take longer to readjust.
While the time frame is different based on the substance and how heavily it is used, physical withdrawal symptoms will normally last somewhere between three to 14 days. Psychological effects are not technically withdrawal, but they may create cravings and other psychological symptoms that last for several months or up to a year in some cases.
Different types of drug withdrawals carry different risks and symptoms. Many types of withdrawals are uncomfortable but rarely life-threatening. The worst types of withdrawals are from drugs that affect brain receptors that influence your risk of seizures. In particular, alcohol and benzodiazepine withdrawals will increase the risk of seizures and are more serious and dangerous than most other types of withdrawal.
Alcohol withdrawal is among the most dangerous types of withdrawal that you can go through. Aside from the unpleasant symptoms that it causes, it can also cause seizures and a dangerous condition called delirium tremens. Symptoms of alcohol withdrawal can include:
Alcohol withdrawal symptoms will normally start within 8 hours, peak within 36 to 72 hours and last for two to 10 days.
Alcohol withdrawal is more likely to be fatal than any other type of withdrawal. Alcohol withdrawal can cause delirium tremens, a life-threatening condition that is fatal in 37% of people who develop it but do not find treatment.
Benzodiazepine withdrawal is considered the second most dangerous type of withdrawal. While benzodiazepine withdrawal does not cause delirium tremens like alcohol withdrawal, it can cause seizures. Symptoms of benzodiazepine withdrawal include:
Short-acting benzodiazepine withdrawals can begin within 24 hours of stopping use and can last two to four weeks. Long-acting benzodiazepine withdrawals take longer, starting two to seven days after the last dose and last two to eight weeks. Anxiety may also be a long-term problem after stopping benzodiazepines.
Withdrawing from benzodiazepines can kill you. This type of withdrawal can cause seizures, which increase your risk of life-threatening harm. It can also cause psychosis, which alters your perception of reality. This can lead you to do things that are unsafe without realizing it.
Heroin withdrawal is unpleasant but not as dangerous as other types of withdrawal. The most dangerous symptoms associated with heroin are due to its use, not its withdrawal. Symptoms of heroin withdrawal include:
Heroin withdrawal can start eight to 24 hours after last use and will typically last four to 10 days, depending on how heavily it is used.
You can die from heroin withdrawal; however, the risk is quite low. Death from heroin withdrawal is normally due to complications like dehydration from excessive vomiting and diarrhea, and it is more common in people who have some kind of pre-existing medical condition.
While prescription opioids are used differently than heroin, they are both the same type of drug. This means the risks and symptoms during withdrawal will be very similar. Like heroin, most of the dangerous risks with opioid prescription medications are connected with their use, not with withdrawal. Symptoms of withdrawal from prescription opioids include:
The time it takes to begin symptoms varies widely based on the specific medication and whether it is formulated to release slowly or quickly. Symptoms can begin eight to 48 hours after the last use and can last between four to 20 days, depending on the specific medication.
Like heroin, it is possible to die from prescription opioid withdrawal but very unlikely. Those who already have existing medical problems and will be more affected by possible complications of withdrawal, such as dehydration, will have the greatest risks. However, these risks are still quite low.
Crystal meth withdrawal (methamphetamine) is generally a less dangerous type of withdrawal, as it creates fewer serious symptoms and is not typically associated with medical dangers. Someone may experience a “crash” in the period immediately after stopping meth, causing them to feel very fatigued and sleep heavily for one to three days. Some of the symptoms of crystal meth withdrawal include:
Most of the withdrawal symptoms from meth following the crash tend to be psychological more than physical. These symptoms can last for several weeks or even months.
You are very unlikely to die from crystal meth withdrawal. The only potential deadly risk that may occur during crystal meth withdrawal is depression that is severe enough to lead to suicidal thoughts. If acted on, this could be deadly. However, this degree of depression is uncommon and usually treatable.
Cocaine withdrawal is similar in some ways to meth withdrawal because both drugs are stimulants. Like meth, cocaine will cause a crash after use is stopped, creating a period of intense fatigue. Following this crash, withdrawal symptoms are mainly psychological. Symptoms of cocaine withdrawal can include:
As most symptoms from cocaine withdrawal are more psychological than physical, there is not a clearly defined cutoff for when they resolve. Most symptoms will be reduced significantly within a few weeks, but some may last for several months.
Like meth withdrawal, death from cocaine withdrawal is quite unlikely. The only scenario in which dying from cocaine withdrawal is a feasible risk is when it leads to suicidal thoughts that are ultimately acted on.
There are essentially three ways a person can go through the withdrawal process. The first is to go at it alone, withdrawing by yourself at home. Depending on the type of withdrawal, this could be very dangerous. The second option is to withdraw at home but with a doctor’s guidance. This option, called outpatient detox, can help those who are unlikely to have severe withdrawal symptoms. The third option is to go through withdrawal in a medical facility. Called medical detox, this option is the best for those who may have dangerous withdrawal symptoms.
Taking care of withdrawal symptoms yourself without talking to a doctor could make your withdrawal experience more unpleasant than it needs to be. In some cases, it could even be dangerous. You should always check with a doctor before going through withdrawal at home.
The best home remedies will involve taking measures to support yourself during withdrawal. These measures could include:
Beware of home remedies that advertise a faster or easier detox. Many of these home remedies focus on getting the drug out of your system more quickly. However, this does not help because withdrawal symptoms only begin once the drug is gone. How quickly the drug is removed only affects when your symptoms will begin, not how severe they will be.
Medical detox is the best way to go through withdrawal. Even if you are not likely to experience dangerous symptoms, medical detox can make the process more comfortable. Medical detox can either be outpatient or inpatient, and it always starts by seeing a doctor or addiction treatment provider.
During medical detox, a doctor will evaluate your withdrawal risks and help you formulate a plan to complete withdrawal. This may include sending you home with medications and checking in on you periodically. In situations where dangerous symptoms may occur, your doctor may want you to stay in a detox facility. At a detox facility, a medical team can monitor you and intervene quickly if any severe or life-threatening symptoms develop.
The medications used to treat withdrawal symptoms vary significantly based on the type of substance used, your medical history, previously experienced withdrawal symptoms and many other factors. Specific medications will be used for some types of withdrawal. For example, benzodiazepines or barbiturates are often used when withdrawing from alcohol.
Often, medications provided during withdrawal are given to manage symptoms instead of withdrawal itself. For example, someone who has high pain levels and is withdrawing from opioids may be given Tylenol to reduce their pain. This doesn’t actually treat the cause of the opioid withdrawal, but it manages the symptom of pain.
Alcohol detox is considered to be the most dangerous type of withdrawal that someone can experience. The risk of dying from alcohol detox increases significantly when delirium tremens occurs, especially if it is not treated professionally. Even without delirium tremens, alcohol withdrawal during detox can cause seizures, hallucinations and other symptoms that can increase the risk of injury or death. Having professional medical support during detox can be life-saving if you are a heavy drinker.
The timeline for withdrawal varies significantly based on the substance, how heavily the substance was used and your overall health. Physical withdrawal symptoms will normally begin within 24 hours for most people and last one to two weeks. Psychological symptoms like cravings are not considered true withdrawal symptoms, but they can last for several weeks or even months.
Post-acute withdrawal syndrome (PAWS) is a set of symptoms that can occur after physical withdrawal is completed. These symptoms are primarily psychological and can include cravings, sleep disturbances, anxiety, depression and mood swings. These symptoms can be experienced after withdrawal from any kind of substance and can last for several weeks or months.
Alcohol acts on GABA receptors in the brain. These receptors help to reduce the likelihood of seizures, but chronic alcohol use reduces the sensitivity of these receptors. When alcohol is stopped, these receptors are not able to reduce the likelihood of seizures as well as they normally do, creating an increased risk of seizures during alcohol withdrawal.
There are two main factors that affect the severity of withdrawal. The first is the type of substance that has been used, as different substances create different withdrawal severities. The second is how heavily the substance was used. This is influenced by a combination of the amount and the frequency of use.
Located in the scenic mountains of Colorado, The Recovery Village at Palmer Lake is a 15-acre facility that is equipped with everything needed to help you detox from any substance as safely as possible. In addition to helping withdrawal be a safer and more comfortable experience, we also provide rehab services that help people to maintain the progress that they make in their fight against addiction.
If you or someone you love is concerned about going through withdrawal, know that you don’t have to do it alone. Our state-of-the-art facility and qualified medical experts can provide you with a safe and comfortable medical detox experience, helping you to successfully take the first step toward a life free from addiction. Contact us today to learn more about what we can do for you.
The Recovery Village aims to improve the quality of life for people struggling with a substance use or mental health disorder with fact-based content about the nature of behavioral health conditions, treatment options and their related outcomes. We publish material that is researched, cited, edited and reviewed by licensed medical professionals. The information we provide is not intended to be a substitute for professional medical advice, diagnosis or treatment. It should not be used in place of the advice of your physician or other qualified healthcare provider.